Stroke/Brain Injury

Why you need to exercise:

After a stroke or brain injury, muscles are often weak (generally on one side more than the other but it depends on where your injury was) and this can have an impact on mobility. Endurance is decreased due to the increased effort to move as well as the extended inactivity. You may notice that your weak side also has spasticity. An article published in the Journal of Neurologic Physical Therapy examines the benefits of exercise post-stroke, and concluded that aerobic exercise was associated with favorable outcomes for cardiovascular health and physical performance.

Ongoing therapy is important to increase the strength of your effected muscles, and improve your mobility; but increasing your fitness is also important. Improved fitness is an important part of decreasing the risk of another stroke by managing risk factors such as hypertension and diabetes.

Besides increasing strength, endurance and balance, a consistent exercise can maintain or increase range of motion of the neck and trunk and the affected and unaffected extremities. It can reduce pain, stiffness, and excessive muscle tone, and improve coordination.
People after a brain injury who did not exercise complained of more cognitive problems or symptoms than did those who exercised, suggesting that exercise may improve abilities such as memory, and thinking.

People who exercised after a brain injury had fewer physical, emotional and cognitive complaints and symptoms, such as sleep problems, irritability, forgetting and being disorganized. They report less depression and more engagement with their social network and community.

What you need to be cautious of with exercise:

Due to the weakness and/or impaired sensation, balance can be decreased. It is important to exercise safely to limit your risk of falls. Even if you are able to walk, you may choose to work out seated to be able to exercise more intensely, safely.

Fatigue while exercising is to be expected. Like everyone else, you will have good and bad days. You can modify these programs to accommodate for fatigue or other conditions. Avoid overexertion and pain. However, some discomfort may be necessary to make progress.

Sometimes memory problems may get in the way of doing exercise regularly or in remembering the details of an exercise regimen. If this is an issue for you, keep a calendar as a reminder of when your exercise is scheduled and recording the dates and time you spend exercising may be helpful. Also log the workout you performed.

It is important to monitor your blood pressure and heart rate with exercise. Also, know what medications you take and how they may impact your exercise performance.

Watch your skin! If you can’t feel an area, always be cautious you aren’t injuring it.

Remember to consult your physician before starting an exercise program.

Resources:

  • www.stroke.org
  • www.strokeassociation.org
  • www.brainline.org
  • Gordon, et al. Physical Activity and Exercise Recommendations for Stroke Survivors. Circulation 2004;109:2031-2041
  • Kluding et al. Exercise and Executive Function in Individuals with Chronic Stroke: A Pilot Study. JNPT 2011;35: 11–17